I attended a video conference today on heath care reform put on by AMSA and the AMA reps in my class. We talked with a senator's aide about the upcoming bills in the Senate and how they may or may not affect us as soon-to-be doctors. We talked about medicare reform, the public option and mandating insurance for all American Citizens. I realized during the talk that part of the problem with heath care today is that it is a business. We want to put the "incentives" in the right spot so more people choose family practice or general surgery in small towns where more people have medicare and doctors get less compensation, so hospitals will cut excess costs and 'medicare fraud', so insurance companies can still make money while paying for our health problems, but still prevent me from having to pay for your medicine. We want to cut costs without sacrificing service, we want to extend care without institutionalizing and assembly-lining it. We want it personal and cost effective.

There are too many conflicting needs in the system. We need to realize that we can't do everything. For the health care system to 1) be more cost effective and 2)less susceptible to litigation requiring "CYA" medicine while 3) keeping medicine personal is impossible. To be more financially solvent requires a movement towards the 'mammograms only starting at 50' type of thought. Preventative care for everyone is not necessarily cheaper than paying for a few people's major problems. We just have to be comfortable with more people dying than absolutely have to if we would have checked everyone starting at 25. In order for the system to be less litigious, we would need universalizable regiments of care, requiring large amounts of paperwork and consulting to create and even more if you think your patient is different than the 'average' person the regiments are designed to be helpful for. If money is the bottom line there is no solution possible.

It was a play about honesty, with oneself and with the world and its about the dreams we often have and almost as often give up on. There was conflict between family and society. Who wins? Save the family and betray the social order, or let lose the family when the greater good calls for it? Who are our families?

There was a doctor in the play. He was really the voice of the writer in this show it seemed. He was the one to bring up life's focus on practicality. We can't always do what we want, because it is not practical. It won't support our family or the lifestyle we wish to display ourselves living. And we give up on those dreams, watching our honesty disappear.

I hope I'm not doing that. It bothers me sometimes to think that what I am doing with my life, everything that's happening with my life, might be happening because its practical, its a "good idea." I get all worked up sometimes worrying about if I'm really being true to myself. And then I realize you can't really know unless you act, unless you do something with your life. I can't sit paralyzed by the fear that I'm not doing what I'm "supposed" to be doing. I'd rather just do things I think will help at the moment with out bothering about the "purpose" behind them or whether it "fulfills" me or not. Whatever I do, if I do it well and my heart is in it, will be what being true to myself means. I get to decide what it means by deciding to act. Because, who am I without action? You are what you do. The tough part is doing it with your heart.

Maybe that's what I'm really worried about...that I don't have a heart with which to do meaningful things or with which will feel the beauty behind the actions.

the begining?

So, I'm not totally sold on my blogs name yet, as I'm not entirely sure how people will take a anarchist doctor, or even if you can BE an anarchist doctor. But this is just a test, to see if I have what it takes to blog and to stick up for my beliefs. And I'm a med student anyway, I don't have to put an MD after my name for a good three years yet.

I've only recently become aware that I have severe anarchist leanings. I was brought up a capitalist, became a socialist for a while (if only in thought), and have come to realize that the most moral and egalitarian position one can take in the world is anarchy. It doesn't assume the stupidity of the masses and the need for a caretaker to oversee societal functioning. It doesn't bank on cut-throat competition among unequals, never-ending consumerism and environmental destruction in exchange for short term gain. Anarchy depends only on the inherent goodness in people. I have a desire the desire to see the world as a good place and a place where people don't need rules to tell them respect for the other is a good in itself. If humanity needs policing to tell them that murder is wrong or that cooperation creates the best outcomes for everyone involved there is something incredibly wrong with how we raise our children. I know it is not a plausable or effective way of running a society and might lead to ruin, but hey, that's what anarchy is against anyway, "running" a society. I belive love and mutual respect and trust are the most moral basis to live by and to interact with others, not laws and edicts, not five year plans or...commandments. If someone slaps you, turn the other cheek. If they slap you again, turn your cheek again. They will eventually tire, or humanity is already lost forever. Thats why I want to be a doctor. I trust people will learn from their mistakes. I will help fix people to the best of my ability, physically, psychologically and spiritually. Some things will be beond my power, and some things will take me to the limits of myself and tear me down. I hope I can take it.